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Recovering the Capacity to Live outside of a Psychiatric Hospital: Impact of a Specialized Inpatient Program

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Abstract

Deinstitutionalization in psychiatry led to a decrease in hospital beds, short hospital admissions focussed on symptoms reduction, and the development of ambulatory care. However, the needs of patients who despite symptoms reduction do not display the minimal competencies to live alone or in a sheltered accommodation, are not met in such a context. They usually go through long admissions and fail to improve. In 2016, we implemented a new inpatient program focused on fostering the development of the competencies needed to adapt to living outside the hospital; the aim of this study was to evaluate if it lead to the resolution of these situations or in contrary if it turned into a long stay unit. 116 patients admitted to the program between 2016 and 2018 were included in the study. They were psychiatric inpatients who had no home, did not find a place in a sheltered accommodation and couldn’t be discharged. In the majority of cases, the situation was resolved within 180 days and the majority of patients was referred to a sheltered accommodation. Functional and symptom levels improved significantly over time. A specific focus on restoring competencies to live outside of hospital allows complex patients to improve their functional level and to find a place to live in the community within a relatively short time. While deinstitutionalization has been beneficial to the vast majority of patients, denying the specific needs of a minority of patients leads to unnecessary long and inefficient hospital admissions.

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Availability of Data and Material

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Route de Cery, 1008 Prilly, Lausanne, Switzerland

    Pierre Lequin, Philippe Golay, Fabrice Herrera, Marie-Anne Brisard & Philippe Conus

  2. Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland

    Philippe Golay

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  1. Pierre Lequin
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  2. Philippe Golay
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  3. Fabrice Herrera
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  4. Marie-Anne Brisard
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  5. Philippe Conus
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Correspondence to Pierre Lequin.

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The authors declare no conflict of interest in relation to the subject of the study.

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Local ethics committee approval and explicit consent were not required because analyses were conducted on existing routine institutional records containing anonymous data.

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Lequin, P., Golay, P., Herrera, F. et al. Recovering the Capacity to Live outside of a Psychiatric Hospital: Impact of a Specialized Inpatient Program. Psychiatr Q 92, 751–759 (2021). https://doi.org/10.1007/s11126-020-09846-y

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  • DOI: https://doi.org/10.1007/s11126-020-09846-y

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